NPIMap

Organization Active NPI

Supportive Living Skills, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Baton Rouge, LA
National Provider Identifier
1871615849
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
14123 Issued in LA
Legal business name
SUPPORTIVE LIVING SKILLS, INC.
Practice address
2055 Wooddale Blvd
Baton Rouge, LA 70806-1516
Phone
(225) 810-9622
Fax
(225) 927-2464
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Kenia Richardson
Title
Program Director
Phone
(225) 810-9622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 14123 LA Primary

Addresses

Primary practice location

2055 Wooddale Blvd
Baton Rouge, LA 70806-1516

Mailing address

2055 Wooddale Blvd
Baton Rouge, LA 70806-1516
Phone (225) 810-9622

Other identifiers 1

IdentifierTypeStateIssuer
1465275MedicaidLA

National Provider Directory

National Provider Directory

Locations

2055 Wooddale Blvd
Baton Rouge, LA 70806
Phone (225) 810-9622

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1871615849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 WOODDALE BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708061516",
            "telephone_number": "225-810-9622",
            "fax_number": "225-927-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 WOODDALE BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708061516",
            "telephone_number": "225-810-9622",
            "fax_number": "225-927-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE LIVING SKILLS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "KENIA",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "225-810-9622",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "LA",
            "license": "14123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1465275",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.